Wenning G K, Jäger R, Kendall B, Kingsley D, Daniel S E, Quinn N P
University Department of Clinical Neurology, Institute of Neurology, London, England.
Mov Disord. 1994 May;9(3):333-6. doi: 10.1002/mds.870090311.
Cranial computer tomographic (CT) images of 33 patients with multiple system atrophy (MSA) and of 40 age-matched controls were blindly analyzed by two neuroradiologists. All patients had autonomic dysfunction, all but one had parkinsonism, and 13 had cerebellar signs. The scans were judged entirely normal in 21%. Moderate or severe infratentorial atrophy was found in 42%. Cerebellar atrophy was present in 39%, and pontine atrophy was present in 18%. Of the 13 patients with cerebellar signs, only eight had cerebellar atrophy. Of the 20 patients without cerebellar signs, five had cerebellar atrophy. Supratentorial involvement was much less common and less severe. Thus, CT demonstrated system involvement that was not evident clinically in five of 33 cases (15%). However, in all five the clinical diagnosis was already evident from the presence of both autonomic and pyramidal signs in addition to parkinsonism. We conclude that CT imaging is of limited diagnostic use in individual patients with MSA.
两名神经放射科医生对33例多系统萎缩（MSA）患者和40例年龄匹配的对照者的头颅计算机断层扫描（CT）图像进行了盲法分析。所有患者均有自主神经功能障碍，除1例患者外均有帕金森综合征，13例有小脑体征。扫描结果显示21%完全正常。42%发现有中度或重度幕下萎缩。39%有小脑萎缩，18%有脑桥萎缩。在13例有小脑体征的患者中，只有8例有小脑萎缩。在20例无小脑体征的患者中，5例有小脑萎缩。幕上受累情况较少见且程度较轻。因此，CT显示33例中有5例（15%）存在临床上不明显的系统受累。然而，在所有这5例中，除帕金森综合征外，自主神经和锥体束征的存在已使临床诊断明确。我们得出结论，CT成像在个体MSA患者中的诊断用途有限。
